Kyrgyzstan

When the Minister of Health gave the go-ahead for Kyrgyzstan’s participation in the pilot phase of MeTA, he expressed particular concern about high medicine prices - despite removal of Value Added Tax - and about limited access to medicines in rural areas.

In January and February 2009 the National MeTA Secretariat and MeTA National Stakeholder Forum developed a draft Action Plan for 2009-2010 to focus on three principal issues rated as of imperative importance in drug provision:

designing and carrying out a public awareness campaign on medicines, focusing on poor quality and counterfeit medicines to be avoided.

Members of the Secretariat and the National MeTA Council acknowledged their awareness of the many other issues needing to be tackled, such as high prices; the non-availability of medicines, especially in rural areas; rational drug use and the use of generics; monitoring of drug side-effects; improving the procurement system and the supply chain; corruption and ethical issues; and appropriate and patient-friendly practice in pharmacies. But the three areas were identified as a good starting point and a base on which to build a transparent and accountable drug supply system, particularly for the poor.

At an International MeTA Secretariat meeting in London in 2008, Kyrgyzstan MeTA’s Co-Director, Mariam Djankorozova, pointed out that the country had been a leader on a number of pharmaceutical issues. It was one of the first to implement a national drugs policy and an essential medicines list, and to offer standardised national treatment guidelines, with training.

But she also cited figures that showed the size of the problems ahead. Rural areas – home to three-quarters of the country’s population – have only one pharmacy for every 4,500 people (the proportion in towns and cities is 1:1,500). Many counterfeit medicines come into the country (and 80 per cent of medicines entering through official channels are withdrawn because of poor quality). The government is unable to stem the flow, partly because the mountainous terrain makes controls difficult, partly because of lack of facilities to differentiate counterfeit from genuine. The drug information system is under-developed: there is an absence of information on price and quality.

In addition, said Ms Djankorozova, many doctors and pharmacists prescribe or recommend highly promoted medicines rather than cheaper products and there are no controls on promotion. It is hoped that MeTA will provide a mechanism for giving information to counterbalance heavy promotion of particular brands.

If MeTA works well, it will have a role to play in tackling all these problems. And it may be able to create a single online space where all information on medicines is accessible to everyone, both consumers and professionals.